Our NHS will continue to struggle until the government recognises the need to address risk factors and access to timely health care: Christine Hancock

After a notable career in nursing, many years as the CEO of the Royal College of Nursing and president of the International Council of Nurses, Christine Hancock (left) realised that healthcare was intervening too late and people were suffering and dying from illnesses that could have been prevented. She founded and directs C3 Collaborating for Health, which works with business, communities, professionals (particularly nurses) and health in the workplace.

She responded to an article by John Burn Murdoch (July 21^st) on the economic risk from the UK’s dwindling workforce.

He reports that chronic illness is the main driver of this stalled labour recovery as – out of roughly half a million Britons aged 15-64 missing from the workforce – two in three cite long-term illness as their reason for not holding or seeking a job:

“Britain’s rise in chronic illness predates the onset of the pandemic.

“With direct impacts of Covid ruled out, the most plausible remaining explanation is grim: we may be witnessing the collapse of the NHS, as hundreds of thousands of patients, unable to access timely care, see their condition worsen to the point of being unable to work. The 332,000 people who have been waiting more than a year for hospital treatment in Britain is a close numerical match for the 309,000 now missing from the labour force due to long-term sickness”.

He pointed out in an earlier article (June 3rd) that the virus may be the proximate cause of economic inactivity, but it’s not the ultimate one, and long-term investment to build capacity and a shift in the balance away from hospital treatment must be addressed to heal Britain’s workforce.

Christine Hancock added that about 60% of the main chronic illnesses (obesity, diabetes, cancer, heart attacks and strokes) which are a burden on the NHS can be prevented by confronting major risk factors such as smoking, what we eat and drink and physical inactivity. She concludes:

“Our NHS will continue to struggle until the government as a whole recognises we need an approach that attacks these risks, especially in the most disadvantaged areas of the country”.

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A reader points out that a notable omission from this article is that the UK workforce lost more than 200,000 European Union citizens working in many sectors, including health, social care, agriculture and construction (Bloomberg cites ONS)

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Lancet study recommends close scrutiny of the private sector’s role in the NHS

“Our findings suggest that further increases in NHS privatisation would be a mistake,” said Dr. Aaron Reeves (below right) University of Oxford) co-author of the study, which may be read here.

The Financial Times (paywall) reports that this research, funded by the Wellcome Trust and published in The Lancet, suggests that the rise in outsourcing from 2013-20 has led to ‘higher rates of treatable mortality’ (deaths from such conditions as heart attack, stroke, colorectal and breast cancer).

Increased levels of outsourcing were potentially linked to an extra 557 avoidable deaths in England. 

The study may be read in full here. Its results were summarised on the Lancet’s website (extract):

We found significant increases in for-profit outsourcing between 2013 and 2020 (appendix p 20). Figure 1 shows the changes in outsourcing since the beginning of April, 2013. Figure 1A shows a 365-day rolling average of total commissioning expenditure received by for-profit companies.

It shows that overall levels of outsourcing to for-profit providers consistently increased since 2013, rising to more than 6% of total commissioner spending in England by 2020 (£323 million out of £4999 million for the first 3 months of 2020). It also shows that the majority of this outsourcing was received by health-care companies . . , Based on observed changes in outsourcing spend and treatable deaths for each health board, the analysis shows 557 additional deaths between 2014 and 2020 might be attributed to changes in outsourcing.

The study analysed details of more than £204bn in outsourcing expenditure from the websites of 173 of England’s 191 regional health boards between April 2013 and February 2020. It found that an annual increase in outsource spending of 1% is “associated with a rise in treatable mortality of 0.38%, or 0.29 deaths per 100,000 population, the following year”.

Co-author Benjamin Goodair (right) said: “While some have argued the Health and Social Care Act [2012] would improve the performance of health services by increasing competition, our findings add merit to longstanding concerns it could instead lead to cost-cutting and poorer health outcomes”.

Dr Reeves said that the findings of this research are timely. as the way ln which England’s health boards are organised is due to be overhauled: “This creates a key moment where the role of the private sector within the NHS must be closely scrutinised.”

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MMR: why not allow the single vaccine option, in use elsewhere and widely accepted in ‘60s & ‘70s Britain?

 

As Dr Michael Jarmulowicz (FRCPath, MBBS) wrote in the BMJ:

“What I find puzzling is the adamant refusal of the authorities to facilitate the availability of the single measles vaccine, to the point that the Department of Health has banned its use within the NHS. How does this fit with the growing acceptance of patient autonomy and patient
choice? . . .

“Other countries with equivalent medical and ethical standards make them freely available.”

Other countries with equivalent medical and ethical standards do indeed make single vaccines freely available – indeed, Japan, a country with an excellent child health record, completely stopped using the MMR vaccine in 1993 after 1.8 million children had been given two types of MMR and a record number developed non-viral meningitis and other adverse reactions

The Merck measles, mumps and rubella (MMR) vaccine is a mixture of live weakened viruses of the three diseases. The first dose is generally given to children around 9 to 15 months of age and a second dose at 15 months to 6 years of age, with at least 4 weeks between the doses, according to PubMed (US government document – though the country’s National Center for Biotechnology Information (Centers for Disease Control and Prevention) states that the vaccine is only licensed for use in children who are 12 months old.

The scientific argument for immunising infants against measles is to establish a good herd immunity, protecting unvaccinated babies, children and adults who could not be given the vaccination.

Doctors and parents are urged to acquire and carefully read the information leaflets relating to whatever vaccine they are considering and an online search of medical journals finds material which would make a thoughtful parent pause before agreeing to have their baby injected with the MMR vaccine.

The World Health Organisation (a UN affiliated body) reports that Live Attenuated Vaccines (LAVs) raise some general safety and stability concerns and lists six. A snapshot of the measles section follows:

Mass measles immunization campaigns – reporting and investigating adverse events following Immunization – notes that seizure risk is age-dependent, and lower for children over six years, who are unlikely to have febrile seizures. Allergies (especially to gelatine) and general illhealth is a contraindication to vaccination with MMR vaccine.

The most common programme error is an infection as a result of non-sterile injection. The infection can manifest as a local reaction (e.g., suppuration, abscess), systemic effect (e.g., sepsis or toxic shock syndrome), or blood-borne virus infection (e.g., HIV, hepatitis B).

Establishing a profitable monopoly

In the U.S. more than a million dollars has been paid in compensation over the last ten years to parents alleging their children were harmed by the MMR jab, Merck and Co USA. Despite this, the manufacturers of Mumpsvax (Jeryl Lynn strain) announced in January 2010 that it would no longer provide mumps vaccines as single doses. The single dose rubella vaccine has also been halted. Single measles vaccines and a combined measles/rubella vaccine are still available.

Prolonged legal action in its tenth year against Merck, the manufacturers of the MMR vaccine.

The Wall St Journal and many other news outlets have reported that Stephen A. Krahling and Joan A. Wlochowski, former Merck virologists, filed a lawsuit in 2010, accusing the drug maker of falsifying data about its mumps vaccine. The case has not yet been settled nine years later and the virologists complain that the company is not making some documents available to the court.

Single vaccines are used privately in Britain

Although separate vaccines for measles, mumps and rubella are now unlicensed in Britain, it is not illegal for doctors and clinics to import the vaccines as long as they inform the Medicines Control Agency (MCA) that they are bringing the vaccine into the country.

Dr Richard Halvorsen, a GP with over 20 years’ experience and the author of OK Vaccines: Making the Right Choice for Your Child (2017), has written widely on the subject. He runs an immunisation service in Britain that offers parents a choice of buying single and small combination vaccines which includes the single measles and measles/rubella vaccines.

Should not all parents have the right to request the single vaccines for measles, mumps and rubella under the NHS system?

 

 

 

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Mass-medication 2: the prevention element – a potential revenue stream?

As Andrew Miles, senior UK vice-president of GlaxoSmithKline observed cryptically in the Financial Times recently, “As much as people might think that the prevention element may not be a revenue stream for the company, it provides phenomenal insights.”

In July, the journal Science Translational Medicine published a report of the trial at Novartis Institutes for Biomedical Research in Massachusetts into a treatment, administered as two daily pills. A Times article noted that it was found to cut the number of infections in older people. Stephen Evans, the professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said that the study was only an incremental improvement on the treatments already available and there are unanswered questions about the possible side-effects of the drugs.

Mass medication is an iatrogenic catastrophe

In June, this view was expressed in a BMJ article by James Le Fanu, retired GP and journalist. He wrote that ‘profligate’ prescribing has brought a hidden epidemic of side effects and no benefit to most individuals. There is no drug or procedure with its “chance of good” that may not harm some. The more doctors do, the greater that risk. Over the past 20 years there has been:

• a dizzying fourfold rise in prescriptions for diabetes treatments,
• sevenfold for antihypertensives,
• and 20-fold for the cholesterol lowering statins.
• Meanwhile the number of people taking five or more different drugs has quadrupled to include almost half of those aged 65 or over.

He continues: “The consequences of this massive upswing in prescribing? A hidden epidemic of immiserating symptoms such as fatigue, muscular aches and pains, insomnia, and general decrepitude, a 75% rise in emergency admissions to hospital for adverse drug reactions (an additional 30 000 a year) …

Proposals have been made in the past for mass or even universal medication by aspirin and statins

The NHS now concludes that the risk of side effects (particularly the risk of bleeding) outweighs the benefit of preventing blood clots. It has long been known that the pills carry a risk of gastro-intestinal bleeding. But a new University of Oxford study, published in The Lancet, suggests that the danger increases far more sharply with age than was thought, according to Professor Peter Rothwell, lead author. A Telegraph artlcle reports on his 2017 findings, adding that taking a daily aspirin is more dangerous than was thought, causing more than 3,000 deaths a year.

Britain is already the “statins capital” of Europe

The UK has the second highest prescribing levels in the Western world, with aggressive prescribing of the medication by GPs, whose pay is linked to take-up of the pills.

In 2014 it was reported that twelve million people (one in four adults) would be told to take statins under controversial new NHS guidelines. Draft proposals from health watchdogs were that the vast majority of men aged over 50 and most women over the age of 60 are likely to be advised to take the drugs to guard against strokes and heart disease. The National Institute for Health and Care Excellence (Nice) had cut the “risk threshold” for such drugs in half and experts said that the number of patients advised to take the drugs is likely to rise from seven million to 12 million.

And current medical guidance says that anyone with a 20% risk of developing cardiovascular disease within 10 years should be offered statins.

Almost all men over 60 and all women over 75 in England qualify for statin prescriptions under guidelines adopted by the National Institute for Health and Care Excellence in 2014, a 2017analysis shows – see BMJ.

However, some health experts have questioned the industry forces behind these studies. The first recommendation was put out in 2013 by the American College of Cardiology (ACC) and the American Heart Association (AHA).  CNN reports that a number of experts who worked on the ACC/AHA guidelines had financial links to drug companies, which they disclosed publicly. No conflicts of interests were reported by the authors of the United States Preventive Services Task Force guidelines, but nearly all of the trials they included in their analysis were sponsored by industry, according to Dr Rita Redberg, who stressed this point in a January 2017 editorial in the journal she oversees. “The ACC did not follow its own conflict of interest guidelines“..

Fluoridation – or any practice that uses the public water supply as a vehicle to deliver medicine – violates medical ethics in several important ways:

• It deprives the individual of his or her right to informed consent to medication.
• It is approved and delivered by people without medical qualifications.
• It is delivered to everyone regardless of age, health or nutritional status, without individual oversight by a doctor and without control of dose.
• The safety of fluoridated water has never been demonstrated by randomized controlled trials–the gold standard study now generally required before a drug can enter the market.

Fluoridating water is a form of mass medication and most western European nations have rejected the practice — because, in their view, the public water supply is not an appropriate place to be adding drugs.

Who profits from all these instances of largescale medication?

 

 

 

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Long, tragic sagas: infected blood transfusions, OP poisoning and Gulf War Syndrome, denial and delay, pending death

The Haemophilia Society has blown the whistle and called for an enquiry into its own failure and that of government, pharma and clinicians. More here.

Medics and politicians knew by the mid-1970s that commercially manufactured blood products from the USA were suspect. By the mid-1980s there were warnings of a similar situation in respect of HIV. Nevertheless these products continued to be imported and used – just as OP sheep dips were.

The lives of British haemophiliacs and other patients in need  of a blood transfusion were blighted in the 1970s and 1980s by these cheap imported US blood products, harvested from inmates and drug addicts. More than 7,000 were infected and went on unknowingly to infect family and friends. Read more in The Journal.

Last week in The Times, Margarette Driscoll recalls that in 2015, following the Penrose report into contaminated blood products in Scotland (which many victims denounced as a whitewash), David Cameron apologised to those who were infected by HIV and hepatitis C.

Weasel words

References to “compensation” have been changed to “payments” – to avoid admitting the liability which is already common knowledge? The sums received by victims of the contaminated blood scandal are known as ex gratia payments.

In April, as he left the Commons, the former health secretary Andy Burnham declared there had been a “criminal cover-up on an industrial scale in the NHS” over contaminated blood and called for a Hillsborough-style inquiry.

Diana Johnson, Labour MP for Kingston upon Hull North, has been campaigning on the issue since she met one of her constituents, a mild haemophiliac who was given factor VIII in 1983 to prevent excessive bleeding when he had a tooth removed in hospital. He discovered he was infected with hepatitis C in 1995, when it showed up on blood tests for an unrelated illness.

As Theresa May had set up the Hillsborough inquiry when she was home secretary, Johnson was hopeful she would do the same for contaminated blood.

May refused. Johnson requested an urgent Commons debate, which was due to be held on Tuesday. She then got the six leaders of the opposition parties — including the DUP — to sign a letter to Ms May asking for an inquiry, and this is to be set up.

Adding insult to injury? Payment to many victims of NHS blood contamination is to be cut

In March this year a scheme to pay the victims of NHS blood contamination is to be scaled back under government plans announced on Monday. Ministers believe the reforms are necessary because more people are now considered likely to develop serious health issues – and be entitled to higher payouts – pushing the programme as much as £123m over budget.

The government has proposed measures that would cut predicted costs, including limiting the availability of the higher level of financial support under the scheme

Will an enquiry compensate these victims for the cuts?

 

 

 

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